Archive for July, 2007

It’s hard to talk about disease management, the state of primary care or emergency room use without mentioning the need for medical homes for all. Just because a patient has a primary care provider, says Commonwealth Medicine consultant Liz Reardon, does not mean that the patient has a medical home. “A medical home is something beyond a primary care office. It’s not a building, it’s an approach. It’s a way of working with patients, working with families and working within the healthcare system.Ã¢â‚¬Â This week in the HIN Weekly Business Update we share more of Liz’s thoughts in this area. The medical home model makes even more sense in the face of predicted provider shortages (the latest just announced in Massachusetts) and baby boomers’ looming demand on the healthcare system.

“Can I get a number 2, extra cheese, large fries, and yeah, you can super-size that. Oh, and can I get a Diet Coke?”

That scenario takes place often among Americans. Despite the obesity epidemic currently consuming this country, people will load up their menus with calories and fat, but often opt for those diet soft drinks.

While diet soda seems to be a healthy choice for the avid soda drinker, a recent study by Boston University shows that drinking more than one regular or diet soft drink a day may be associated with an increase in the risk factors for heart disease and other chronic diseases, the subject of this week’s Disease Management Update

A picture may be worth a thousand words, but so may a few minutes of audio. In this week’s podcast, hear how a dose of positive psychology enhances a live health coaching session with a female struggling with hypertension. Also, Roger Reed of Gordian Health Solutions paints a picture of a great health coach, and a study shows that corporate America isn’t giving up on wellness even as evidence of ROI eludes them. Corporate wellness should target the frighteningly high numbers of drug users and heavy alcohol users in the workplace posing a serious threat to worker safety and productivity, according to a new SAMHSA study.

In this week’s Disease Management Update, we spotlight culture-specific health issues. A recent study by the University of Southern California concluded that Mexican immigrants living in the United States are healthier than their Mexican-American counterparts. The study noted that the latter group is more likely to suffer from high blood pressure, high cholesterol, higher Body Mass Indexes and diabetes.

Given the culture we live in today where everything is super-sized Ã¢â‚¬â€ including many of our bodies Ã¢â‚¬â€ and the only exercise many Americans get is extending their arms to pay the drive-through fast food cashier, it’s not really surprising that Mexican-Americans are worse off in the health department than their native-born cousins.

The element that should hit home, however, is that this study goes beyond the health status of Mexican-Americans; it is sad commentary on the health of all Americans, regardless of country of origin. The study offers reasons for this difference in health, suggesting that the generations of Mexicans born in the United States have adopted the Ã¢â‚¬Å“AmericanÃ¢â‚¬Â habits of eating fast food, smoking and not exercising.

In a live coaching demo, “Coach Meg” (Wellcoaches CEO Margaret Moore) helps volunteer client Kathy Smith (not her real name) identify life issues that are keeping her from being her “best self” in managing her thyroid condition and weight issues. You’ll hear how Coach Meg builds positive psychology into this real-life health coaching session, which was conducted as part of “Teaching Health Coaches to Integrate Positive Psychology with Physical Health to Improve Disease Management Outcomes,” a July 18, 2007 audio conference now available on CD-ROM or via an On Demand re-broadcast on the web. Order the conference CD-ROM or register to listen to the On Demand re-broadcast today.

New research by the University of Rochester School of Medicine and Dentistry is suggesting that personal disclosures by physicians are not beneficial to the doctor-patient relationship, and may actually hinder the flow and the efficacy of the visit. This data may come as a surprise to those of us who have been reassured by a physician’s anecdote or who have become more comfortable with our doctors through friendly conversation.

Scott Baio is 45Ã¢â‚¬Â¦and single. And that’s the theme of VH1’s latest Ã¢â‚¬Å“celebrealityÃ¢â‚¬Â show. Coming to grips with being middle-aged, Baio experiences a mid-life crisis of sorts and calls in a life coach Ã¢â‚¬â€œ Doc Ali Ã¢â‚¬â€œ to guide him through this trying time in his life.

By incorporating this novel idea into their reality show, Baio and VH1 may be having the best week ever. The idea of Ã¢â‚¬Å“coachingÃ¢â‚¬Â is very hot in today’s culture, especially in the healthcare industry. Health coaches provide patients with one-on-one information on a variety of health issues, help them monitor their health status and get them to work more closely with their doctors. And employers are using this method to promote behavior change in their workers whether they need to start exercising, quit smoking, employ healthy eating habits, reduce stress, manage chronic conditions and more.

And now HIN has jumped on the reality bandwagon with a July 18, 2007 audio conference that features a live health coaching session. Industry expert Margaret Moore, CEO, Wellcoaches Corporation, will coach a female struggling with weight issues and hypertension. It may not be Ã¢â‚¬Å“The Biggest Loser,Ã¢â‚¬Â but conference participants will have the opportunity to ask questions on the techniques Moore uses during the coaching session following the demonstration.

This 90-minute audio conference will serve as a training session for health coaches on theories and strategies to improve coaching outcomes through the integration of mental and physical health.

In recent audio conferences on managing care transitions for the frail elderly, we've heard how conducting a falls risk assessment can help assure an elderly patient's safety and smooth the transition from hospital to home. ShirleyBOARD.com, a social networking site for caregivers, offers a checklist in this area:

Reduce slipping hazards by removing throw rugs or securing them in place with double-sided carpet tape, tacks or rubber mats placed underneath. Do the same with stair treads.

Remove furniture that may be easy to trip over.

Replace door knobs with lever handles on all doors.

Remove thresholds from doorways and entryways that may be easy to trip over. Ramps are a good way to do this.

Install sturdy, stainless-steel hand rails in the shower/bathtub and next to the toilet. Installing grab bars on the edge of the tub is a good idea too. Make sure all hand rails and grab bars are anchored securely.

Install a walk-in shower to avoid the need to climb over the edge of a tub.

Put a rubber mat and a sitting bench in the bathtub/shower to eliminate slipping or loss of balance.

Provide dustpans and brooms with long handles so that your loved one doesn’t have to bend over to pick up trash.

Put in nightlights in the bedroom and hallway so that your loved one doesn’t have to fumble around in the dark.

Make sure that all sitting furniture has arms so that your loved one can easily lower themselves or stand. Sitting surfaces should not be so low or high that your loved one has difficulty sitting in them or standing up out of them.

The ShirleyBoard is an online community for people caring for aging loved ones. Originally developed to help its founder with the responsibilities of caring for his aging mother diagnosed with Alzheimer’s in 2005, the free site allows caregivers to centrally store important information, keep a log of daily activities, and network with other caregivers.

In this week’s HIN Business Weekly Update, the title of the featured white paper from Cohorts — All Patients are Not Created Equal — could not be more apt. Many of this week’s newsmakers are tapping new media to market to their respective populations, from health plans speaking the urban language of 20-somethings to hospices offering e-support to long-distance caregivers via the Internet. Also, SAMHSA has a new toolkit — a media mix of print, posters and CD — to attack the problem of fetal alcohol spectrum disorders in native populations.

Is your organization wading into new media waters — podcasts, video, text messaging or blogging, for example — to broaden its reach, or just trying to figure out what it all means? Post a comment here and let us know.

According to a new survey by the Campaign for Tobacco-Free Kids, most United States citizens are in favor of the proposed cigarette tax hike. With a projected 7 percent decline in underage smoking and 4 percent decline in overall smoking, not to mention the $54 billion produced in long-term healthcare savings, Americans can clearly see the benefits of the $.75 per-pack increase.

Download this FREE report for data on the top clinical targets of healthcare case managers; the top means of identifying and stratifying individuals for case management; and the most common locations of embedded or colocated case managers.